Nice place but you wouldn’t want to live there because places like this routinely elevate appearances well above the person. We also know exactly how events unfolded after Lorraine Bayless collapsed and a nurse on duty called 911.

From the Bakersfield Californian…

In a seven-minute audio recording posted on KGET’s website, the dispatcher asked the nurse whether anyone was present “that’s willing to help this lady and not let her die.” The nurse’s reply:

“Um, not at this time.” The nurse went on to say that it was against the facility’s policy for staff to perform CPR on the woman, who KGET reported had collapsed in a Glenwood dining room.

The center’s executive director, Jeffrey Toomer, did not return a message left at his office Sunday. But the center did issue a written statement reiterating its “deepest sympathies and condolences” to the woman’s family, and said it was “conducting a thorough review of this matter.”

Take a listen to the 911 dispatcher begging the on-duty nurse to do something to help a dying woman— if your stomach can take it: 911
Audio.

I understand that there could be mitigating circumstances in this case but the heartlessness with which the facility’s nurse prioritized facility policy above the life of a person reveals all too much about the dark underbelly of ageism in America.

About Dr. Bill Thomas, ChangingAging.org

Bill is a visionary leader in the online Changing Aging movement and a world-renowned authority on geriatric medicine and eldercare. Bill is founder of two movements to reshape long-term care globally – The Eden Alternative and Green House Project. He is currently traveling the country influencing culture change with the Age of Disruption Tour.

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Reader Interactions

Comments

As a personal care nurse I struggle with this issue all the time. I may have an elder that has a DNR order BUT the state of PA says I have to resusitate because at that moment the elder cannot speak for him/her self. I feel terribly guilty when I have to go against the wishes of an elder who has been telling me time and time again that they want to die.

The only time I can follow the elder’s request is if they choose to go on hospice. And we all know people that want to die and do indeed have acute episodes. Statitics show how unsuccessful CPR is in elderly. So I have to watch my elder be abused after death by staff and EMTs.

It’s a horrible feeling when you truly have a personal relationship and KNOW what the elder wants.

My name is Felix and I am an AGNG 200 student at the Erickson School of Aging. Procedures are procedures, when it comes a question of ethics and morality it’s often a paradox. So let’s not blame the ones who has followed the policies and really ask yourselves would you have done something different?

My name is Lena Fink and I am an AGNG 200 student at the Erickson School of Aging. It is sad that situations like this one are the reasons many older people have negative perspectives on entering a nursing home. Unfortunately, we see circumstances like the one stated all too often. It puts a bad name on nursing homes. It is such a shame, the lack of human decency the workers at this institute had. With a woman collapsed nearby, it would be human instinct to help, however; it seemed as if even a call to 911 was overstepping boundaries. From what I’ve learned about aging thus far, elderly people are afraid of many things as they age- isolation, disability, etc. Food, shelter, and common human decency should not be other things to add to their list of worries.

My name is Joseph Lee and I am a AGNG 200 student at the Erickson School of Aging. I don’t understand how saving another human being’s life can not take priory when it comes to a situation where it is feasible. In fact, even though the executive director of Glenwood had disclosed to the residents that their staff would not assist them themselves when emergencies arise, I question why the residents themselves would not be confused of the reasons. I abhor the fact that a trained “nurse” who was present at the time of miss Lorraine Bayless’s need of help refused to perform what she was trained to do. Why would she acknowledge that she was a trained “nurse” if she neglects to preserve the life and health her institute’s residents. Anyone can call 911, she just neglected her duty as a medically qualified citizen who was present at a time when her skills seemed necessary. In a society where the old are seemingly cared for, why does it seem as it they are being nothing more than goldfish. Though they are given food, shelter, and some medical attention, they are not cared for enough to save even when it is highly possible? Because there are so many other older members of society that can easily replace them each single life does not deserve our society’s attention? Our old is what defines our past and should be better acknowledged for their deep wealth of what made our society to become what it is and has at the present.That is what still lies as a huge problem is today’s “ever growing society”. Until this problem is solved, society is digressing far from what we can ever hope to become.

My name is Mary Milligan and I am a AGNG 200 student at the Erickson School of Aging. I personally, do not understand the rationale for facilities having these types of policies, and if they are known why people are choosing to send themselves there. I am disgusted with how heartless these people are, putting their job before the life of another person they are suppose to be taking care of. In class, we have learned that growing old is suppose to be a celebration, and a time when you can instill your wisdom into the ones around you. I feel like facilities like this are almost like sending them a place where they have nothing to look forward to; not even a person who cares enough to save their life. While this is more of a debate of whether or not this nurse was in the right to not treat this person, I think that these facilities in general aren’t healthy to a person growing old. We need to celebrate and embrace growing old, not removing them and hiding them from society.

I am from a family that believes in talking about end of life issues and doing everything under our power to make sure the decsions a person has thought long and hard about, are carried out to the best of our abilities. Advance Directives and DNRs are legal documents to protect the person and also their family, doctors and facilities from having to make that decision for an individual. I would have been heart broken if the facility my Father was in or the hospital my Mother spent time in, chose to perform “heroic” treatments when both of them had specific orders/legal documents not to do so. The one sided reporting and I believe sensationalism of this woman’s death is what some of us continually fight against so we can make our own choices, even in death.

Sadly, I wasn’t at all surprised at this situation. In the twenty years that I’ve worked with facilities, I encountered variations of this policy. One particular facility threatened staff with immediate dismissal if they violated the policy that they could take no action in an emergency situation without the director present. including called 911. One resident had fallen out of bed, was lying on the floor in agony, apparently from a fracture. The aide couldn’t reach the director, so she did nothing. When the director was finally reached it was morning and the resident had died. I don’t blame the aide. She was a single mother on minimum wage. Had she been fired, she wouldn’t have gotten another job in this city.

Shouldn’t there also be discussion of dignity and respect for persons by not stripping them naked to preform chest compressions in a public, facility dining room, in front of how many other residents?
Medical or Social Service ethics professionals, any thoughts?
Dr. Arletta Wallace, PhD

Time to start running heart attack drills… No joke. Contemplate how to run them for a few moments and one will find that they could be run for free, quickly, and just as often as fire drills. Go ahead and say that you think it’s a terrible idea… I’m still not going to ask for permission to fake heart attacks when I eventually get to the point that they are the best entertainment I can find… And when the chest pains (that have already sent me to the hospital ER once) come again for real… I know I’ll be in good hands.

If all that doesn’t seem very polite, try visiting a modern home where there is a fire alarm box in EVERY elder’s room. An alarm designed to physically push you out of a room with it’s disorienting lights, and painfully piercing sound… Regardless of whether or not you can actually do something about safely getting out of that room/your bed on your own. That kind of disturbance is not conducive to anything beneficial for some people, and it could be downright unsafe if they to escape such an environment in a panic. That’s not very polite, especially when there is ALWAYS a crew of staff to help me if I really need it. I trust they’ll check on me, and close the door (like they are supposed to) and let me sleep/go right back to sleep if all is well.

If regulations are going to force someone to force a fire drill on me, I’m going to pay somebody back in kind.

We may scare the heck out of each other, but when a true Emergency 911 event actually does arise, we will be able to do our jobs that much better. Besides, all these trials by pseudo-fire are bonding experiences that we can talk about, make assessments of, and improve on with time. FYI: To date, I have not addressed the issue of potentially misplaced fire alarms directly but trust that I do intend to eventually. That’s another battle for another day, when I’ve figured out enough of the steps required to navigate the system in a manner that come up with a functional solution. One more step.

People like that nurse put policy above the individual need because they’re too afraid of their own job security and too afraid to break the rules. And because often they’re not bright enough to realize that exceptions and emergencies must always prevail.

Bill, this is shocking and unconscionable. It’s an atrocity to the profession of nursing and to the mindset of the care of older women and men.

The important issues in this story are not being discussed, because it’s too easy to sink to the ‘being mean to grandma’ level. I expected better of Bill Thomas.

The general public is not aware that there is not always a medical benefit to CPR. The longterm survival after CPR declines with age and underlying conditions. CPR is very aggressive and often leads to a few additional days in intensive care followed by death.

Most people don’t understand the levels of care provided in independent living facilities and how it’s different from a skilled nursing facility. Since many people utilize these facilities, they should understand what is and isn’t being provided. This is a great opportunity to educate and begin discussion.

Somehow as a society we have decided that it’s appropriate to bring out the big guns in fighting off death in older adults. Let’s be clear that much of this thinking is thanks to Medicare. There is money to be made by prolonging the dying. How many stories have I read on this website and others about dying people undergoing unnecessary procedures that cause undue suffering with no medical benefit.

I’m certainly not advocating an arbitrary age restriction on services, but let’s look at the complexities of this situation, and not take the easy road of sensationalism.

Brenda your comment is much appreciated. As I noted, there may be mitigating circumstances here. However it remains shocking to image a hotel clerk standing by while a customer died on the lobby floor. What’s the life of an elder worth, that’s the question that is gnawing at me. I do hope you continue to advance the conversation with thoughtful comments like this.

Apparently the staff member who was present was not a nurse and was probably not trained in CPR. A couple of other points: CPR is not what we see on TV. The average overall survival rate with CPR: 22% – the survival rate for the elderly: 5% – in the meantime, CPR may bust ribs and crack the sternum. As my fire chief said when I asked his opinion, “Would you want to go through such excruciating pain with those odds?”

Even if the staff member wasn’t a nurse, she was still a human being dealing with another human being in deep trouble. “it was against the facility’s policy for staff to perform CPR on the woman” – I understand that CPR can break bones because I too am qualified in it, but you can’t just call 911 and watch a woman die. You just cannot do that.